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Endocrine Abstracts (2021) 73 AEP16 | DOI: 10.1530/endoabs.73.AEP16

1Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia, Department for Obesity, Metabolic and Reproductive Disorders; 2Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Department for Obesity, Metabolic and Reproductive Disorders, Serbia; 3Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Serbia, Serbia; 4Faculty of Medicine, University of Belgrade, Serbia


Introduction

The connection between obesity and tumorigenesis has been well established.

Aim

The aim of this study was to elucidate if there are any demographic and functional differences in adrenal incidentalomas (AI) with respect to different body mass index (BMI) categories.

Patients and methods

This was an observational, cross sectional study. The AI cohort consisted of 680 patients that underwent functional hormonal assesment in our Clinic. After exclusion of patients with overt adrenal hyperfunction, malignant adrenal tumors, adrenal cysts and metastasis, the total studied group consisted of 560 patients: 385 female and 175 male. Based on BMI, we have stratified them in three groups, 18.5–25 kg/m2 (135 patients, 22.44 ± 2.03 kg/m2, 56 ± 11 years), 25–30 kg/m2 (219 patients, 27.63 ± 1.41 kg/m2, 58 ± 11 years) and > 30 kg/m2 (206 patients, 33.91 ± 3.53 kg/m2, 59 ± 9 years). Based on cortisol level after 1 mg overnight dexamethasone suppression test, AI were identified as nonfunctional AI (NAI) (≤ 50 nmol/l), those with possible autonomous cortisol secretion (PACS) (> 51 nmol/l) or autonomous cortisol secretion (ACS) (> 138 nmol/l).

Results

Female sex was predominant in all BMI groups (M/F %: 22.6/77.4, 40.5/59.5 and 27.1/72.9). However, obese and normal weight patients had significantly higher frequency of females when compared to overweight patients (P < 0.001). Obese patients were significantly older then the other two BMI groups (P = 0.008). Overweight and obese AI patients were more likely to have NAI (P < 0.001) whereas normal weight AIs were more likely to have either PACS or ACS (P < 0.001). All three BMI groups had predominantly more unilateral then bilateral AIs (70.7/29.3%, 79.1/20.9% and 77.8/22.2%). There was no difference in frequency between unilateral and bilateral AIs with respect to BMI group (P = 0.172). There was a significant positive correlation between patients› age and BMI (r = 0.097, P = 0.022). There was no significant difference in the size of AI between the groups (P = 0.292).

Conclusion

Our results imply that the typical obese patient with an AI is very likely to be a menopausal female with an unilateral nonfunctioning tumor. They also add to the body of evidence that obesity plays an important role in the adrenal tumorigenesis. However, there is yet to be determined which came first: the hen or the egg?

Volume 73

European Congress of Endocrinology 2021

Online
22 May 2021 - 26 May 2021

European Society of Endocrinology 

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